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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. . NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this peIlit lay be subject to .deed restrictions. wbieb laY be lOre restrictive than City
<br />regulations. !he undersigned assllles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, tbey lay be required to be licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor laY be
<br />cited for a .isdeieanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requireleDts JaY apply for the intended work, they are advised to contact the City of Zephyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtberlOre, if the owner bas hired a contractor or contractors, he is advised to bave tbe contractor(s) sign portions of the
<br />.Contractor Sections. of this application for whicb they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wisbes you to sign
<br />as contractor that lay be an indication that be is not properly licensed and is not entitled to peIlitting privileges in the
<br />City of Zepbyrbills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN f.AW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, bave been provided with a copy of .Plorida's Construction Lien Law - IGeolmer's Protection
<br />Guide. prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleODe other than the
<br />.owner., I certify that I have obtained a copy of the above described docUleRt and prOlise in good faith to deliver it to the
<br />wowner. prior to cOlleDcelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developaent.
<br />
<br />Application is hereby tade to obtain a perlit to do work and installation as indicated. I cert~fy that no work or
<br />installation has c~ced prior to issuance of a perlit and that all work will be perfoIJed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlent regulations in th~ jurisdiction. I also
<br />certify that I understand that the regulations of other goverDlental agenCies laY apply to tbe intended work, and that it is
<br />If responsibility to identify what actions I lUst take to be in cOlpliance. Sucb agencies include but are not li.ited to:
<br />t Departlent of Bnvironaental Regulation - Cypress Bayheads, Wetland Areas and BnviroRlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />t Southwest Florida Water Managetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />· AIIf Corps of Engineers - Seawalls, Docks, lfavigable Waterways
<br />t Departlent of Health i Rehabilitative Services, Environaental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />· US Bnvironaental Protection Agency - Asbestos abateleDt
<br />I also certify that, if fill laterial is to be used in Flood Zone .AW or HA,etc.., it is understood that a drainage plan
<br />addressing a .coapensating volute. will be subtitted whicb is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit. issuance.
<br />
<br />. l perltt issued sball be construed to be a license to proceed with tbe work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall is~uance of a peIlit prevent the Building Official fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued shall becmIe invalid
<br />unless the IOrk authoriled by sueb peIlit is co.enced within sil IOntbs of issuance, or if IOrk authorized by the penit is
<br />suspended or abandoned for a period of sillOntbs after the tile the work is COBeIlced. One 90 day f!Jtension of tile, II8J be
<br />allowed for the penit with fee ebarge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection ..st be logged during eaeb sil IODth period, or the project will be considered abandoned.
<br />IIARHIIfG TO (MI!R: YOUR FAILURE TO RECORD A NOTICE OF aJIMEICmIIIIf MAY RBSULT IN YOUR PAYING "'ICE FOR DIPROVIIIIITS TO YOOR
<br />PROPIIm'. IF YOO IIlmD TO OBtAIN FINANCING, CONSULT WITH YOUR LIIIDBR OR AN AnoRm BEFORE RECORDING YOUR JfOfICE OF
<br />COMMDCIMBNt'. JOBS UNDER $2,500 IN VALUE DO NOT NBED TO RECORD AND POST A .NOTICE OF COMMENCEMm'.
<br />
<br />SIGMAfUIlB: 0IflfER OR AGBJIT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OP FLORIDA
<br />coom OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19_____ by
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />I
<br />
<br />i
<br />
<br />J
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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